The Specific Aims of this renewal application for a Midcareer Investigator Award in Patient-Oriented Research are 1) to develop and evaluate the efficacy of behavioral interventions designed to increase dietary adherence, improve health outcomes, and enhance quality of life for young children with cystic fibrosis, type 1 diabetes, and those at risk for obesity, and 2) to provide the candidate protected time and resources necessary to mentor postdoctoral fellows and junior faculty members in psychology and pediatrics who are pursuing clinical investigation in behavioral nutrition interventions for children. The Candidate's programmatic research has focused on identifying behavioral factors that compromise dietary adherence and translating this knowledge into behavioral interventions that can be tested in rigorous clinical trials. During the course of this award, the candidate will complete research studies with young children with cystic fibrosis, type 1 diabetes, and those at risk for obesity. For each population, the objective is to establish the efficacy of behavioral treatments through well-designed clinical outcome studies and disseminate the findings so that standard care for these children can be improved. The candidate also has an established track record of providing mentorship to postdoctoral fellows and junior faculty in psychology and pediatrics. The Research Plan includes two projects: an NIH/NIDDK competing continuation R01 clinical trial, "Behavioral &Nutrition Treatment to Help CF Preschoolers Grow," and a new longitudinal study focusing on "Prospective Evaluation of the Effect of Parent Feeding Strategies on Child Eating and Weight in Low-Income African American Preschoolers." In addition, the candidate will continue his research focused on dietary adherence in young children with type 1 diabetes. The Mentoring Plan for beginning clinical investigators will consist of 1) individualized mentoring of postdoctoral fellows on an NIDDK T32 training grant focused on research training in child behavior and nutrition research, 2) training and supervision of the postdoctoral fellows in the development of their own independent research proposals, and 3) participation of postdoctoral fellows in established didactic programs on manuscript and grant writing, design of clinical trials and clinical research methodology, and ethics in clinical research. Cincinnati Children's Hospital Medical Center provides an ideal setting for continuation of this award because of the commitment to patient-oriented research, the presence of a strong pediatric General Clinical Research Center, and ongoing initiatives to promote innovative clinical research including the Behavioral Core of the GCRC and the interdisciplinary training grant in Child Behavior and Nutrition Research (T32). The public health goals of the candidate's research program are to develop better treatments for young children and their families that can improve the current standard of dietary care and to train the next generation of patient-oriented researchers in this area